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2. First Name*
3. Last Name*
5. Paso Robles Library Card Number (14 digits, beginning with 22138)*
7. Mailing Address (where packages are received)*
9. City*
10. State*
11. Zip*
13. Phone Number*
14. Email Address*
16. Title 1*
17. Author
19. Format of Requested Item*

    1. Book
    2. CD Audiobook
    3. Large Print Book
20. ISBN (if known)
22. Title 2
23. Author
25. Format of Requested Item

    1. Book
    2. CD Audiobook
    3. Large Print
26. ISBN (if known)
28. Title 3
29. Author
31. Format for Requested Item

    1. Book
    2. CD Audiobook
    3. Large Print
32. ISBN (if known)
34. Additional Comments
36. Zip Book Request Terms

    ► I can submit three (3) ZIP Books requests per month.► The book(s) will be delivered to the address indicated above. ► I will return the book(s) directly to a Paso Robles Library book drop and clearly identify it as a ZIP Book. ► My account will be charged the full price of each item if not returned.

38. Do you agree?*

    By clicking "I agree," you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) by signing in this alternate manner, your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature.

    1. I Agree
40. Signature of person making the request*
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42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit Submit and Print

* indicates a required field